Ophthalmic Plastic Surgery /7

12 ) Cosmetic eyelid surgery

Objectives

Objectives are to correct ageing changes of eyelids :

• eyebrow ptosis,
• excess upper lid skin,
• excess of orbital fat...
• Sometimes younger patients are concerned by their appearance : protuberant fat in the lower lids

Upper eyelid and lower eyelid orbital fat prolapse

Upper lid blepharoplasty and transconjunctival lower lid blepharoplasty

Examination

After determining the patients complaints and expectations, clinical examination includes :

-for upper eyelids, position and symmetry of the eyebrows, position of the skin crease, evaluation of excess of preseptal skin, excess orbital fat, asymmetry of amount or location of fat, measurement of lid height and function of levator muscle

-for lower lids, evaluation of orbital fat, excess lid skin, hypertrophy of the pretarsal orbicularis muscle, lid laxity.

 

Orbital lower lid fat prolapse	Result after transconjunctival lower lid blepharoplasty
Preoperative	Postoperative
Preoperative	Postoperative

Blepharoplasty surgery serve to remove excessive tissues, including skin, muscle and fat.

Orbital fat in young patients lower lids may be removed via a transconjunctival approach.

Rhytids of lower eyelids, canthal skin ('crow's feet') and temple may require laser CO2 resurfacing.

Excess of upper eyelid skin associated with rhytids of lower eyelids and canthal skin	Upper lid blepharoplasty associated with lower lid and ¨crow's feet ¨ laser CO2 resurfacing
Preoperative	Postoperative
Preoperative	Postoperative

Conclusion :

A successful oculoplastic surgery lies on a strong knowledge of eyelid, lacrimal and orbital anatomy and functions.

Surgical procedures are chosen with a systematic approach, in order to satisfy all the complaints from a lot of patients.